Provider Demographics
NPI:1679906341
Name:BRINE, ALEXANDRIA ROSE (BCBA)
Entity Type:Individual
Prefix:
First Name:ALEXANDRIA
Middle Name:ROSE
Last Name:BRINE
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1573 FALL RIVER AVE
Mailing Address - Street 2:
Mailing Address - City:SEEKONK
Mailing Address - State:MA
Mailing Address - Zip Code:02771-3740
Mailing Address - Country:US
Mailing Address - Phone:508-617-8396
Mailing Address - Fax:
Practice Address - Street 1:1 MIDDLE ST UNIT 2E
Practice Address - Street 2:
Practice Address - City:FAIRHAVEN
Practice Address - State:MA
Practice Address - Zip Code:02719-6603
Practice Address - Country:US
Practice Address - Phone:774-274-3099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-16
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst